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NPI Code Detail

MEDICARE: SILVER SKIES DERMATOLOGY LLC

MEDICARE: SILVER SKIES DERMATOLOGY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207N00000XDermatology Physician

General Provider Information

NPI Number : 1518771971
Entity Type Code : Organization
Provider Name (Legal Business Name) : SILVER SKIES DERMATOLOGY LLC
Provider Business Mailing Address
First Line : PO BOX 344
Second Line :
City : HIGLEY
State : AZ
Zip : 85236-0344
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1618 E PINE ST
Second Line :
City : SILVER CITY
State : NM
Zip : 88061-7155
Country : US
Telephone Number : 575-342-4546
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JOSHUA BENSON
Credential :
Telephone Number : 801-927-8711
Provider Enumeration Date : 02/05/2025
Last Update Date : 11/26/2025

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Directions to “SILVER SKIES DERMATOLOGY LLC ” Practice Location

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